Active NPI
Marysa Wilcox
- Counselor
- Yonkers, NY
National Provider Identifier
1053784488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1156 N Broadway
Yonkers, NY 10701-1108 - Phone
- (914) 965-3700
- NPI assigned
- Nov 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1156 N Broadway
Yonkers, NY 10701-1108
Mailing address
1156 N Broadway
Yonkers, NY 10701-1108
Phone (914) 965-3700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WVE061 | Other | NY | MEDICARE |
| 1285628552 | Other | NY | AGENCY |
| 00355940 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446768000000",
"number": "1053784488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1156 N BROADWAY",
"city": "YONKERS",
"state": "NY",
"postal_code": "107011108",
"telephone_number": "914-965-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1156 N BROADWAY",
"city": "YONKERS",
"state": "NY",
"postal_code": "107011108",
"telephone_number": "914-965-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "MARYSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-06",
"last_updated": "2015-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "WVE061",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCY",
"identifier": "1285628552",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00355940",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yonkers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.